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  • Title: MRI for local staging of endometrial carcinoma: Is endovenous contrast medium administration still needed?
    Author: Bonatti M, Stuefer J, Oberhofer N, Negri G, Tagliaferri T, Schifferle G, Messini S, Manfredi R, Bonatti G.
    Journal: Eur J Radiol; 2015 Feb; 84(2):208-14. PubMed ID: 25440994.
    Abstract:
    PURPOSE: To compare the diagnostic performance of T2-weighted images (T2-WI)+contrast-enhanced T1-weighted images (CE T1-WI) with the one of T2-WI+diffusion-weighted images (DWI) in the assessment of myometrial and cervical stromal infiltration by endometrial carcinoma (EC). MATERIALS AND METHODS: Institutional review board approved our retrospective study; requirement for informed consent was waived. 56 patients with histologically proven EC who underwent preoperative MRI and surgery at our Institution over a 34 months period were included. Two radiologists independently evaluated T2-WI+CE T1-WI and T2-WI+DWI of each patient. Confidence in imaging evaluation (0-3), depth of myometrial invasion (</≥50%) and presence of cervical stromal infiltration (Yes/No) were assessed. MRI findings were compared with pathological ones. RESULTS: Confidence in imaging evaluation was higher for T2-WI+CE T1-WI (2.83/3) than for T2-WI+DWI (2.62/3). T2-WI+DWI showed a better diagnostic performance than T2-WI+CE T1-WI in recognizing deep myometrial infiltration by EC (accuracy, sensitivity and specificity of 0.89, 0.89 and 0.89 vs. 0.86, 0.84, 0.86; p>0.05) whereas both imaging sequences combinations showed the same diagnostic performance in recognizing cervical stromal infiltration (accuracy, sensitivity and specificity of 0.95, 0.98 and 0.80, p>0.05). CONCLUSION: T2-WI+DWI can reliably replace the "classical" combination T2-WI+CE T1-WI for local staging of endometrial carcinoma.
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